NEW YORK(Reuters Health) - Regular exercise can help
people with dementia think a little more clearly, and care for
themselves a bit more, a new study finds.

"If the person with dementia is living at home, there are
usually exercise programs offered at community day programs for
persons with dementia. I would encourage family caregivers to
connect with these programs and/or home care to learn about the
available resources in their community," said Dorothy Forbes, an
associate professor at the Faculty of Nursing, University of
Alberta in Edmonton, who led the study.

For patients with dementia who can no longer live at home,
"Most residential settings should be offering exercise programs
for their residents," Dr. Zaldy Tan, a dementia expert who was
not involved in the new study, told Reuters Health. "If not,
family caregivers may wish to advocate for these."

People are considered to have dementia if their mental
function is bad enough to interfere with daily activities.
Alzheimer's disease is the most common cause, accounting for
about 60 to 80 percent of cases. The next most common cause of
dementia is stroke.

Dementia leads to poorer quality of life for patients, and
it also puts a burden on families and caregivers - as Forbes,
who led the study, knows all too well.

"For over 20 years I worked as a community health nurse
where health promotion was my focus and in home care where I
attempted to support and provide the needed resources with many
family caregivers and persons with dementia in rural and inner
city homes," Forbes told Reuters Health in an email. "My mother
also had dementia and died in an acute care setting where the
health care providers did not understand how to care for her
dementia symptoms."

"These experiences made me realize how difficult it was to
care for someone with dementia at home and in other care
settings, especially with little knowledge about what was
helpful in managing the symptoms and available resources,"
Forbes said.

"There is strong evidence regarding the benefits of exercise
on older adults, but we did not know if there were benefits for
persons diagnosed with dementia," she explained.

In 2006, therefore, when "there was little research
conducted in this area," Forbes and her colleagues pooled the
data from four studies of the role of exercise for patients with
dementia. Their new study, published online by the Cochrane
Library, is an update of that earlier effort.

"This updated review includes 16 trials," Forbes said. "We
plan to do another update in six months as additional trials
have already come to our attention. There is now a great deal of
interest in this area of research."

The 16 trials altogether involved nearly a thousand elderly
adults with dementia. Each trial tested the effects of exercise
programs on such outcomes as thinking skills, activities of
daily living, challenging behavior, and depression.

All 16 trials were so-called "randomized, controlled
studies," which means the research teams used the most
dependable methods. Even so, the studies utilized different
types and duration of exercise programs, and the participants
were in different stages of dementia, so the results were not
uniform.

Still, despite the differing nature of the studies, Forbes
and her team found that on average, exercise improved cognitive
functioning and the ability to perform activities of daily
living.

"Exercise is not only beneficial for older adults (in
general) but also for persons with dementia in delaying memory
problems and prolonging their ability to care for themselves
(i.e., activities of daily living such as dressing, bathing),"
Forbes said.

Exercise didn't have an effect on depression or mood,
however, and there wasn't enough evidence to draw firm
conclusions about its effects on other outcomes.

"I think it's really important topic," Tan, who is the
medical director of the Alzheimer's and Dementia Care Program at
the University of California, Los Angeles, told Reuters Health.

"The challenge here is, as the authors pointed out, that
these studies they reviewed were quite heterogeneous," he said.

"But with that said," he added, "it's promising that even
with quite different interventions and studies, they found that
it appears to be beneficial for cognition and also activities of
daily living."

Tan sees a practical side to exercise that goes beyond its
impact on measurable cognitive skills.

"I think exercise is one intervention that's going to turn
out to be good for other things like, for example, reducing
one's risk for falls," he said. "Falling is one thing that is a
big problem for people with dementia."

Tan expects to see more research in the future, including
studies of how exercise programs might affect the children and
caregivers of people with dementia.

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